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Biomedical subjects

B Shpitz

Publications and source records attributed to B Shpitz.

At least 37 records · Page 2Linked to original sources

Comparative dual label study of first and second generation antitumor-associated glycoprotein-72 monoclonal antibodies in colorectal cancer patients.

Radiolabeled first-generation anti-tumor-associated glycoprotein-72 (TAG-72) monoclonal antibody (MAb), B72.3, has proven useful in detecting primary and secondary colorectal carcinoma. It has been anticipated that the development of second-generation, higher affinity, anti-TAG-72 MAbs, CC49 and CC83, would be of greater use in cancer detection and of value in radioimmunotherapy of human cancer. We compared the pharmacokinetics, biodistribution, and immune responses of 131I-labeled CC49 and CC83 to 125I-labeled B72.3 by preoperatively coninjecting dual-labeled MAbs into 16 colorectal cancer patients. The imaging properties of radiolabeled CC49 and CC83 were also assessed. Pharmacokinetics of all three MAbs were identical, and there were no differences in the uptake of any of three MAbs in tumor and normal tissues. Maximum tumor uptake was 0.0041% of the injected dose/g for 125I-B72.3, 0.0024% for 131I-CC49, and 0.0029% for 131I-CC83. Radiolabeled CC49 and CC83 detected most known tumor sites on scintigrams without any clear advantage for either MAb. Nonspecific splenic and testicular uptake was frequently observed. Anti-idiotypic human anti-mouse antibody responses were seen more frequently with B72.3 than with CC49 or CC83. We conclude that higher affinity, radiolabeled anti-TAG-72 MAbs can detect colorectal cancer but do not penetrate these tumors more effectively than B72.3. Improvements in tumor detection and radioimmunotherapeutic strategies will likely require the administration of smaller fragments of MAb molecules or novel delivery systems rather than the continued development of higher affinity MAbs.

Adult↗

K-ras mutations in aberrant crypt foci, adenomas and adenocarcinomas during azoxymethane-induced colon carcinogenesis.

Ras mutations are an important early event in a number of carcinogen-induced rodent tumors. Colon carcinogenesis induced in rats by azoxymethane is a useful model as it mimics the adenoma-carcinoma sequence observed in humans. In addition, aberrant crypt foci develop in the rat and these lesions appear to be potentially important precursors to adenomas in colorectal cancer. Recent studies have shown that specific K-ras codon 12 and 13 mutations are present in up to 66% of carcinogen-induced rat colon adenocarcinomas. We studied the frequency of these mutations during the aberrant crypt focus-adenoma-carcinoma sequence in azoxymethane-induced Fisher F344 rats. K-ras codon 12 GAT and codon 13 GAC mutations were detected with a sensitive assay based on the amplification of DNA using the polymerase chain reaction. No mutations were present in normal mucosa. Of 27 aberrant crypt foci, K-ras mutations were identified in 2 lesions containing 5 and 10 aberrant crypts, respectively. Mutations were present in 1 of 23 and 10 of 27 adenomas and adenocarcinomas, respectively. These data suggest that K-ras mutations play a role during the stages of carcinogenesis in azoxymethane-induced rat colon cancer. The demonstration of a genetic mutation in aberrant crypt foci provides further evidence for the significance of these lesions as precursor markers of malignant potential during colorectal tumorigenesis.

Adenocarcinoma↗

Intra-rectal injection of tumour cells: a novel animal model of rectal cancer.

The purpose of this study was to develop an animal model of rectal cancer. Three murine-derived cell lines, B16 melanoma, CT26 and MCA38 colon carcinoma, as well as the human colon cancer cell line LS174T were injected into the submucosa of the mouse rectum. Subcutaneous CT26 anbd B16 tumours and intra-caecal CT26 tumours served as controls for tumourigenicity of the cell lines. B16 melanoma produced a locally aggressive rectal tumour as well as skin and para-aortic lymph node metastases. CT26 produced local tumour when injected intra-rectally and colon tumours and liver metastases when injected into the caecum. MCA38 and LS174T intra-rectal injections resulted in large rectal carcinomas without metastases. We believe that growth of a colon cancer cell line in the rectum approximates the human disease more closely than other models of colorectal cancer. We would expect that the model could similarly be utilized to assess the effects of novel adjuvant treatments for rectal cancer as well as in the study of the tumour biology of rectal cancer.

Adenocarcinoma↗

[Ultrasonic examination of the abdominal wall in surgery].

Ultrasonic (US) examination is a simple, effective and quick method of investigating the abdominal wall. We evaluated various cystic and solid lesions in 26 patients by US. In 24 the US diagnosis was correct and revealed pathologic conditions of the abdominal wall such as abscesses, cellulitis, metastatic tumors and hematomas. In 2 patients lesions of the abdominal wall were missed. All but 3 patients were treated surgically.

Abdominal Muscles↗

[Metastatic malignant melanoma of the small bowel as a surgical emergency].

2 cases of metastasis of malignant melanoma to the small bowel presenting as surgical emergencies due to obstruction, are reported. In both cases there was no other evidence of metastatic spread at the time of surgery. Segmental resection of involved bowel was performed, providing satisfactory palliation. This reinforces the opinion that surgical resection of symptomatic metastases of malignant melanoma to the small bowel is justified, despite the poor prognosis of the disease itself.

Female↗

Definitive management of acute pilonidal abscess by loop diathermy excision.

A simple technique of definitive management of acute pilonidal abscess is described. The procedure consists of incision with drainage of pus followed by controlled excision of diseased tissue and lateral sinuses, using a loop diathermy. It allows one-stage definitive management of both acute pilonidal abscess and chronic pilonidal sinuses.

Acute Disease↗

Bleeding esophageal varices and portal hypertension caused by arteriovenous fistula of splenic artery.

Splenic arteriovenous fistula is a rare but curable cause of portal hypertension. This report describes a patient with such a disorder, presenting with bleeding esophageal varices and ascites. It emphasises the importance of performing selective catheterization of the celiac and superior mesenteric artery in all patients with signs of portal hypertension without evidence of chronic liver disease. Etiopathology and management are discussed.

Arteriovenous Fistula↗

Cecal diverticulitis presented as a cecal tumor.

Seven patients diagnosed as having acute appendicitis were operated on and a cecal wall mass due to cecal diverticulitis was found. In two patients the mass could not be separated from the cecal wall and right colectomy was performed. In five patients, in whom the mass could be separated from the cecum, conservative operations (three diverticulectomies and two wedge resections) were performed, thus avoiding needless, more extensive surgery.

Acute Disease↗

Pyogenic liver abscess.

A retrospective study of 18 adults admitted to Meir General Hospital with pyogenic liver abscess during the years 1982-88 was conducted. Our most useful diagnostic tool was ultrasound, which was accurate in all 15 patients in whom it was performed. Only two patients presented with multiple abscesses. Increased alkaline phosphatase was the most predictive laboratory finding, seen in all but one patient. One person was treated conservatively by antibiotics only. In one patient the abscess drained spontaneously into the right thoracic cavity. Initial surgical drainage was done in nine patients and percutaneous catheter drainage in seven. Only one patient died, of septic shock, yielding a mortality rate of 5.5%. The treatment-related complication rate, observed in almost half of the patients, was high. All patients with such complications required repeated drainage, which was achieved surgically in all cases.

Adolescent↗

Metachronous leiomyosarcoma in colostomy after abdominoperineal resection for rectal carcinoma.

Leiomyosarcoma of the colon is a rare neoplasm. It is widely known that primary malignant lesions may present either simultaneously (synchronous tumor) or at different times (metachronous tumor). The incidence of metachronous colonic mucosal carcinoma is generally considered to range from 3 to 5%. Metachronous leiomyosarcoma in colostomy 4 years after abdominoperineal resection for rectal carcinoma is unusual and we have found no reports on this in the literature. The clinical symptoms, diagnostic features, and mode of treatment are discussed.

Adenocarcinoma↗

Desmoid tumor--review and follow-up of ten cases.

Ten cases of desmoid tumor, diagnosed, treated, and followed during the past 11 years, were reviewed and the patients reexamined. Two were up to 3 years, two up to 5 years, and four up to 11 years after excision. The remaining two patients were lost to follow-up. The 10 patients included one male and nine females; six females were of childbearing age and three were postmenopausal. In four females the desmoid tumor was located near various surgical scars. In the one recurrent desmoid it was most probably related to both repeated traumatization of the abdominal wall due to pregnancies and hyperestrogenism. All the surgical margins of resection were microscopically involved by the process. An open liver biopsy, performed simultaneously with the excision of the recurrent desmoid, showed benign nodular hyperplasia compatible with hyperestrogenism. Estrogen and progesterone receptors of this desmoid were negative. In the present series follow-up revealed, in contrast to general agreement, that in spite of incomplete excision, the recurrence rate was low. We suggest that the surgical approach to desmoid tumors could be less radical, except possibly for lesions in patients with multiple causative factors.

Abdominal Neoplasms↗

Bilateral primary malignant lymphoma of the breast.

A rare case of bilateral primary malignant lymphoma of breast in a 76 year old woman is presented. The lesion was examined by electron microscopy and immunochemistry. The diagnosis of primary malignant lymphoma remains a diagnosis by exclusion and requires extensive work-up to exclude widespread malignant process. The behaviour of this malignancy tends to be an aggressive one and the prognosis is generally poor.

Aged↗

Primary gastrointestinal lymphoma: a review of 21 cases.

A retrospective study of 21 patients who had suffered from gastrointestinal lymphoma was carried out. Gastric involvement was more common than involvement of the small or large intestine and carried a better prognosis. Gastrointestinal lymphoma generally occurs most frequently during the fourth to seventh decades of life. In our study, however, five lymphomas occurred in patients under 20 years of age. Clinical symptoms were nonspecific, and abdominal mass was found in only 15% of the patients on clinical examination. All patients were explored, 17 underwent resection, and 4 laparotomy and biopsy. Five-year survival was much better for patients who had undergone resection. Survival was inversely proportionate to the extent of nodal spread. Multiple lesions on the same organ yielded a 5-year survival of 20%, while a single lesion offered a 55% chance of 5-year survival. Diffuse histiocytic lymphoma was the commonest type, followed by the poorly differentiated lymphocytic type. A longer survival rate was present in the lymphocytic type. However, the highest survival rate was in those patients in whom definite resections of the lesion were performed followed by radiation and chemotherapy, especially for gastric tumor.

Adolescent↗

Anal erotic instrumentation. A surgical problem.

Anal sexual eroticism is a fact of modern life and a part of the male homosexual relationship. A delineation of surgical problems associated with anal erotic instrumentation with enema is presented. The cases of three patients with rectal perforation are described.

Adolescent↗